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Objective:To explore the effect of tibial nerve vibration on triceps surae spasticity in stroke survivors and its electrophysiological mechanism.Methods:Thirty stroke survivors with upper limb spasticity were randomly divided into a treatment group and a control group, each of 30. Both groups were given routine rehabilitation training while the treatment group was additionally provided with local vibration of the tibial nerve with an amplitude of 0.3mm at 60Hz. Before and after the treatment, the modified Ashworth scale (MAS) and Clonus grading were used to assess muscle tone and spasticity. Electrophysiological functions were evaluated using the tibial nerve motor and sensory conduction test and F wave and H reflex sensing.Results:Before the treatment there were no significant differences between the two groups in their average MAS scores, Clonus grading, maximum H amplitude (Hmax), the ratio of maximum H to maximum M amplitude (H/M) or the intensity of stimulus required to elicit Hmax. After the treatment, however, all of those measurements had improved significantly in both groups with the average improvements in the treatment group significantly greater than those in the control group.Conclusions:Local vibration of the tibial nerve combined with traditional rehabilitation is more effective than traditional rehabilitation alone in relieving triceps surae spasticity and reducing muscle tone after a stroke. The vibration seems to inhibit excitation of the reflex pathway.
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Objective:To determine the value of lung function, cannula diameter and swallowing function in predicting the success of tube blocking in patients with severe neurological diseases so as to standardize the tracheal decannulation procedure.Methods:The tracheotomy tube blocking of 28 neurological disease patients was studied retrospectively. Before their tracheotomy tubes were blocked the patients′ lung function and swallowing function had been evaluated, and sputum volume and endotracheal tube diameter had been recorded.Results:The five most useful predictors of success in tracheotomy tube blocking were FVC, FVC%, FEV1 (L), FEV1 (L), FEV1 (L) and PEF(L/S). Their OR values were all greater than 1, indicating good predictive power. FEV1 and PEF showed the best predictive power, with OR values of 81.70 and 27.77, respectively. There was no significant difference between the two groups in terms of the other indicators. FEV1 predicted that the best truncation value for tracheotomy tube blocking success is 0.42L, achieving a sensitivity was 100% a specificity of 63.64%, and a correction index of 0.636.Conclusion:FEV1 values can be a useful predictor of successful tracheotomy tube blocking. Using it should improve the success rate of tube decannulation.
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Objective To observe the effect of aerobic exercise combined with impedance training on the blood pressure variability and other blood-related indexes of patients with hypertension. Methods Ninety patients with essential hypertension were randomly divided into group A, group B and group C, each of 30. All were treated with conventional anti-hypertensive drugs. Groups B and C additionally underwent 40 minutes of aerobic training and group C also received resistance training. There were 3 training sessions a week for 12 weeks. Each subject's 24 h systolic blood pressure (24hSBP), 24 h diastolic blood pressure (24hDBP) and their standard deviations were ob-served before and after the 12 weeks. Blood indexes were examined and a plasma arteriosclerosis index was calculated. Results Before the treatment, there were no significant differences in any of the average measurements among the three groups. After the treatment, the average 24hSBP and 24hDBP of all three groups had decreased significantly, but larger decreases were observed in groups B and C. Compared with group B, the average 24hSBP and 24hDBP of group C had decreased significantly more. The average levels of atherogenic index of plasma ( AIP) and lipoprotein phospholipase A2 of groups B and C were significantly lower than before the treatment and also significantly lower than group A's average. The decrease in group C was significantly greater than in group B. Conclusions Anti-hyperten-sive drugs can lower blood pressure, but cannot effectively control blood pressure variation, reduce blood lipids or im-prove the arteriosclerosis index. Long-term, regular aerobic exercise can decrease these indicators and reduce cardio-vascular disease risk in elderly patients with hypertension. Aerobic exercise combined with mild to moderate circulato-ry resistance exercise is more effective than aerobic exercise alone.
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Objective To observe the effects of hyperbaric oxygen combined with rehabilitation training on the motor ability of ischemic stroke patients.Methods Eighty ischemic stroke patients were randomly divided into a treatment group and a control group,with 40 cases in each group.The control group was treated with Bobath' s approach,while the treatment group was treated with Bobath's methods supplemented by hyperbaric oxygen therapy.The United States National Institutes of Health Stroke Scale (NIHSS),the Fugl-Meyer motor assessment scale (FMA) (lower part) and each patient's maximum walking speed (MWS) were used to evaluate the patients before,and after 8 weeks of treatment.Results After treatment the average NIHSS score,FMA score and MWS were 4.17 ± 1.4％,31.2 ± 3.3 and 54,.3 ± 16.2 m/min,respectively,in the treatment group.The control group' s results were 6.81 ± 1.2％,26.2 ± 2.2 and 45.6 ± 18.3 m/min.The intra-group differences in evaluation results before and after treatment were statistically significant in both groups.An inter-group comparison showed that the treatment group performed significantly better after treatment than the control group in terms of FMA and MWS.After treatment,the treatment group showed significantly better walking performance in terms of cadence,stride length,step length on the affected side,gait cycle and double support duration.Conclusion Hyperbaric oxygen can make rehabilitation training more effective in improving the neurologic deficits,motor function and walking ability of hemiplegic stroke survivors.
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Objective:To observe the therapeutic effect of nerve block therapy guided by electric stimulation on the relief of pain and the improvement of function in patients with low back pain(LBP).Method:A total of 78 LBP patients were divided into nerve block treatment group(n=40)and traditional treatment group(n=38)randomly.The nerve block treatment group was injected with Betamethasone compound 2mg and Lidocaine 2ml guided by electric stimulation.The physical modalities and exercises therapy were applied in the traditional treatment group.The pain was evaluated with visual analogue scale(VAS)before treatment and 1 d,1 and 2 weeks after treatment.The function of lumbar was assessed before and after the treatment with performance assessment scale for the treatment of lumbar vertebral diseases.Result:The effective rate in treatment group was 100.0%,in traditional group was 86.8%:the improvement rate in treatment group was 96.6%.in traditional group was 64.3%:there were significant differences between two groups (P<0.01).Conclusion:Nerve block therapy guided by electric stimulation display significant effect on relief the low back pain and improve the function of lumbar vertebrae.
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Objective To observe efficacy of percutaneous laser disc decompression (PLDD) and its correlation with plasma levels of β-endorphine and substance P in patients suffering from protrusion of lumbar intervertebral disc (PLIVD). Methods Seventy-eight patients with PLIVD were randomly divided into two groups, one group (40 patients) treated with PLDD and the other (38 patients) treated with lumbar spine traction and physical therapy as control. Their peripheral plasma levels of β-endorphine and substance P were measured before the procedure and one day, one week and four weeks after it, respectively.Meanwhile, the visual analogue scale (VAS)was applied to assess their pain index. Results Plasma level of substance P was (186±66) ng/L and (419±82) ng/L, and (127 +83) ng/L and (322 +47) ng/L,in treatment and control groups, one day and one week after the procedure, respectively, and that of β-endorphine was (313 ±27) mg/L and (187 ±56) mg/L, and (364 + 18) mg/L and (211 +39) mg/L,one day and one week after it, respectively ( all P ＜ 0. 01 ), with its clinical efficacy of 90% (36/40)and 66% (25/38) one week after it, respectively ( P ＜ 0. 01 ) . Four weeks after it, plasma level of substance P was (64 ±50) ng/L in treatment group as compare to that in controls (93 ±75) ng/L, and that of β-endorphine was (410 ± 21 ) mg/L and (317 ± 42 ) mg/L, respectively, with efficacy of 95% (38/40) and 84% (32/38), respectively. Conclusions Plasma level of substance P can be reduced and that of β-endorphine can be increased by PLDD in patients with PLIVD, thus relieving their pain.Measurements of substance P and β-endorphine can be used as objective indicators to evaluate clinical efficacy of PLDD.